A worrying trend in Social Anxiety: To what degree are worry and its cognitive factors associated with youth Social Anxiety Disorder?

Background: Comorbidity between Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD) is extremely common. This study investigated whether factors commonly associated with GAD, including worry, intolerance of uncertainty (IU), positive and negative beliefs about worry (PBW, NBW), negative problem orientation (NPO) and cognitive avoidance (CA) were associated with SAD severity, symptoms and overall functioning. Method: Participants included 126 youth aged 8-17 years (M=11.29, SD=2.67, Males n=50) with a primary diagnosis of SAD. Participants and a parent underwent a diagnostic interview and completed questionnaires at pre- and 12-week post assessment, and 6-month follow-up. Correlations and hierarchical multiple regression analyses were conducted. Results: Each of the cognitive variables, with the exception of PBW, was found to correlate with SAD symptoms, SAD severity and overall functioning. NPO emerged as an important predictor of SAD severity, self reported ratings of SAD symptoms, and poorer levels of overall functioning. IU and worry also predicted self rated SAD symptoms. Limitations: Measures were chosen on the basis of their sound psychometrics however some were yet to undergo rigorous testing with youth populations. The study design is cross-sectional, which restricts firm conclusions regarding causal and temporal associations between the variables. Conclusions: Findings from this study have implications for the specificity of GAD and SAD in youth. Further research is required to understand whether these cognitive variables play a maintaining role in youth SAD and the extent to which they might influence treatment.